This is an Integrated School Health Programme implemented in ILembe district with the aims of: Preventing new HIV, STI’s, TB and unintended pregnancies among high school learners through education, testing and referral; increasing uptake of health services by learners; and strengthening community support and inter-sectoral collaboration that would improve referral pathways, the delivery of adolescent-friendly HIV and reproductive health services.
4 high schools (Nombika, Mashiyamahle, Hloniphani and Mzingezwi High Schools) in Ndwedwe district of ILembe district.
Funding Cycle: January 2014 to September 2016
The program was expanded in August 2015, moving from Phase 1 of the program which targeted one co-ed high school (n=1 355) to 4 high schools reaching 3 306 learners. The Kheth’Impilo SRH&R school team established referral pathways for learners from the school to a primary health facility offering youth-friendly SRH&R services and where necessary referred them to social and welfare services. The total headcount of SRH&R visits for the period October 2014- September 2015 was 1 897 and of these 1 110 were new visits.
In phase 1, 93% of learners participated in an anonymous baseline survey which showed that learners experience multiple challenges such as food insecurity, gender-based violence and gaps in their knowledge with regard to HIV causation, cure and treatment. Girl learners experienced high levels of teenage pregnancy (14% pa), menstrual-related absenteeism (45%), and poor knowledge about puberty.
A total of 1 158 (86%) of learners completed the 12-module training course and graduated with certificates of completion of the SRH&R program. Post-training surveys showed significant improvement in HIV knowledge, attitudes and behaviour amongst learners and an increased uptake of SRH&R services both at the school and YFC.
An afterschool youth-friendly health service was initiated on weekday afternoons and Saturday mornings. The utilization of SRH&R increased exponentially with 81% of learners seeking school-based SRH&R prevention services. Of these, 61% were referred to a youth-friendly clinic. The uptake of the school-based services was largely driven through self-referral (89%).
Voluntary Male Medical Circumcision (VMMC) uptake was 39% and 40% of learners in phase 1. A total of 573 learners opted for HCT, 326 for contraception and 233 males for MMC for the period October 2014 to September 2015 .
Counselling services have been initiated both for individuals and groups with a total of 1 110 new cases of counselling sessions offered for HCT, STI and contraception. 57 learners disclosed their HIV status and 53 reported to be on ART.
Partnerships have been established between the school, the school governing body and the relevant sectors such as the departments of Social Development, Education and Health. Private sector partners have been involved through an initiative that targeted the female learners’ access to sanitary pads and education on sanitary hygiene, puberty and life-skills. A total of 520 packs of reusable pads were provided to the female learners as 45% of females identified this as an ongoing challenge to their school attendance.
Dr Najma Shaikh
Dr Najma Shaikh
Dr Shaikh is an infectious disease Epidemiologist and has worked extensively in the public health sector in South Africa. She completed an MPH in Epidemiology at Columbia University New York, as a Postdoctoral Fogarty Fellow in 1994. She was awarded the Oliver Tambo Fellowship for Public Health Leadership, and has a graduate Diploma in Health Management, from the University of Cape Town. She previously worked as a Senior Specialist/ HIV/AIDS in the HIV/AIDS Directorate of the Western Cape Department of Health and headed the Epidemiology and Surveillance Unit of the Western Cape Department of Health. Dr Shaikh has worked as an academic, researcher and health manager during the course of her career. Her main expertise centres on the epidemiology of HIV, TB and STI’s, HIV surveillance, mortality surveillance, health systems research, monitoring and evaluation of programs in the public health sector.